Using Patient Brain Dynamics to Personalize Deep Stimulation for Treating Epilepsy

ABSTRACT

Epilepsy is a disease characterized by disruption of normal brain electrophysiology that produces seizures. It afflicts approximately one percent of the world’s population and is the neurological disorder with nearly the highest mortality rate, second only to stroke. The primary treatment for epilepsy is oral anti-epileptic drugs (AED). However, approximately one-third of individuals who suffer from the chronic seizures do not get adequate relief from any AED. In such cases, the most common alternative therapy is an evaluation of locations of putative seizure foci in the brain – typically mapped using invasive intracranial recordings to maximize the accuracy of spatial localization – followed by surgical resection or ablation of foci. However, foci located in eloquent brain tissue are not considered appropriate surgical targets. And such surgery, no matter where in the brain the targets are located, can produce neurological deficits. Also, patients after surgery often still require continued use of AEDs along with their associated side-effects. Hence a therapy that can treat intractable epilepsy with high efficacy that does not require brain tissue destruction is urgently needed. Exogenous electrical stimulation can modulate neural activity in the brain. Hence, the use of deep brain stimulation (DBS) could be an important therapeutic modality for modulating pathological rhythms in the brain. However, the two FDA-approved devices that are currently being implanted in such patients use a very simple stimulation strategy that generally produces disappointing results. Our laboratory has taken an alternative approach that has produced results suggesting a pathway for personalizing DBS to individual epilepsy patients that can greatly increase its clinical efficacy.

BIOGRAPHY

Dr. Mogul is Professor Emeritus of biomedical engineering in the Biomedical Engineering Department at the Illinois Institute of Technology. He received his B.S. degree in Electrical Engineering at Cornell University and his M.S. and Ph.D. degrees in Electrical Engineering/Computer Science at Northwestern University. He subsequently pursued a postdoctoral fellowship in Neurobiology at the University of Chicago. His research interests are in brain electrophysiology and neuromodulation of brain activity via techniques that are invasive (deep brain stimulation) and noninvasive (transcranial magnetic stimulation, or TMS) in order to treat neurological and psychiatric disorders.